tag:blogger.com,1999:blog-7423880838207203660.post6115073857886611086..comments2024-01-10T09:56:49.324-05:00Comments on Respiratory Therapy Cave: A world of bronchodilator lies!!!Rick Freahttp://www.blogger.com/profile/01132949384071592216noreply@blogger.comBlogger12125tag:blogger.com,1999:blog-7423880838207203660.post-75387708169229043632015-04-24T14:06:35.658-04:002015-04-24T14:06:35.658-04:00Breathing treatments are expensive, and should not...Breathing treatments are expensive, and should not be doled out unless there is a notable indication. Just because a person has a disease is no indication for bronchodilators. Mr. Short, we appreciate your comments, and respect your opinion. Still, we are still looking for evidence to support the profligate use of albuterol. John Bottrellhttps://www.blogger.com/profile/05107035756753427035noreply@blogger.comtag:blogger.com,1999:blog-7423880838207203660.post-32910315594312380682015-04-24T14:01:23.048-04:002015-04-24T14:01:23.048-04:00Evidence that the truth hurts before it makes you ...Evidence that the truth hurts before it makes you better. What you say sounds good in theory, but the clinical evidence does not match the theory. This is often the case in medicine. Rick Freahttps://www.blogger.com/profile/01132949384071592216noreply@blogger.comtag:blogger.com,1999:blog-7423880838207203660.post-22561240575007271502015-04-19T03:49:20.459-04:002015-04-19T03:49:20.459-04:00Wow, reading this page is just painful. Stop think...Wow, reading this page is just painful. Stop thinking you're some kind of expert, because you're obviously not. <br /><br />Of course bronchodilators work best in athsma where there is a lot of bronchoconstriction, but you don't seem to understand that small amounts of bronchoconstriciton can be present in the acutely ill lung!<br /><br />Furthermore, you need to understands that bronchodilators are not "anti-bronchospasm medicines"....they actually just relax the muscles in the lungs. That means, even someone with emphysema, yes emphysema, will have every so slightly increase in lumen size of the airways simply due to the muscles relaxing.<br /><br />Lastly, your remark on mucous clearance is laughable. It is a cornerstone of chest physiotherapy that bronchodilators open up the airways and make it more EFFECTIVE for chest clearance techniques. E.G. you can get a much more effective cough if your airways are open.<br /><br />Geez, you are a disgrace.Anonymoushttps://www.blogger.com/profile/08378530353014805946noreply@blogger.comtag:blogger.com,1999:blog-7423880838207203660.post-16418267680614398312014-05-08T15:19:03.256-04:002014-05-08T15:19:03.256-04:00Just the fact albuterol increases sputum productio...Just the fact albuterol increases sputum production in no way proves it benefits patients with pneumonia. If this were true, then patients with asthma and COPD, who are known to have excessive goblet cells and increased sputum production, would be immune to pneumonia. <br />John Bottrellhttps://www.blogger.com/profile/05107035756753427035noreply@blogger.comtag:blogger.com,1999:blog-7423880838207203660.post-47396821744977803122013-02-23T23:39:26.769-05:002013-02-23T23:39:26.769-05:00Very good info!Very good info!Mkai0https://www.blogger.com/profile/03728254674089508411noreply@blogger.comtag:blogger.com,1999:blog-7423880838207203660.post-22374405115551318422010-07-29T06:31:07.552-04:002010-07-29T06:31:07.552-04:00Great post, Rick. I have to say I agree with every...Great post, Rick. I have to say I agree with everything you write here. You should also note that doctors are quick to use a study that shows beta adrenergics slightly enhance sputum clearance to justify giving more treatments, regardless that the effect of this is pretty much insignificant. Yet they ignore studies that show that Albuterol may actually cause bronchospasm. It's one of those I-like-the-study-when-it-supports-my-argument, and ignore it when it disproves my argument kind of deal. John B. RRTAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-7423880838207203660.post-77415172850982823002010-07-26T15:06:07.479-04:002010-07-26T15:06:07.479-04:00For evidence that beta adrenergics do not have a s...For evidence that beta adrenergics do not have a significant enough mucociliary clearance effect, check out <a href="http://www.rcjournal.com/contents/09.07/09.07.1159.pdf" rel="nofollow">this</a> link. The name of the article is "Inhaled Adrenergics and Anticholinergics in Obstructive Lung Disease: Do They Enhance Mucociliary Clearance?" By Ruben D. Restrepo, MD, RRT, of the September, 2007, issue of Respiratory Care (Vol 52, No 9).<br /><br />Here is the highlight of the article: "The involvement of the cholinergic and adrenergic neural pathways in the pathophysiology of mucus hypersecretion suggests the potential therapeutic role of bronchodilators as mucoactive agents. Although anticholinergics and adrenergic agonist bronchodilators have been routinely used, alone or in combination, to enhance mucociliary clearance in patients with obstructive lung disease (CF, COPD, asthma), the existing evidence does not consistently show clinical effectiveness."Rick Freahttps://www.blogger.com/profile/01132949384071592216noreply@blogger.comtag:blogger.com,1999:blog-7423880838207203660.post-89730566488525113482010-07-19T17:39:50.110-04:002010-07-19T17:39:50.110-04:00However, all this extra work does keep us small to...However, all this extra work does keep us small town RTs in business. It's all those poor RTs who work for larger hospitals who are overwhelmed and burned out because they have to wake patients up for therapies they don't need.Rick Freahttps://www.blogger.com/profile/01132949384071592216noreply@blogger.comtag:blogger.com,1999:blog-7423880838207203660.post-8961043507456251802010-07-19T17:37:43.509-04:002010-07-19T17:37:43.509-04:00Also, yes you are correct that most needless breat...Also, yes you are correct that most needless breathing treatments are ordered due to things like Medicaid and Medicare that will only reimburse the hospital if the patient meets intensity of service. And, according to this, a breathing treatment qualifies a patient for reimbursement (at least in Michigan). <br /><br />Yet how a committe decided that a bronchodilator will help a patient with pneumonia is based not on science but theories that are unfounded. It's either ignorance or lies.Rick Freahttps://www.blogger.com/profile/01132949384071592216noreply@blogger.comtag:blogger.com,1999:blog-7423880838207203660.post-13119531355916844102010-07-19T17:27:55.280-04:002010-07-19T17:27:55.280-04:00Just keep in mind this is a blog and not a science...Just keep in mind this is a blog and not a science journal. However, if you've read my other posts, I've provided ample evidence that bronchodilators dilate bronchioles and nothing more. And yes, they will help move secretions IF those are secretions trapped by bronchspasm.Rick Freahttps://www.blogger.com/profile/01132949384071592216noreply@blogger.comtag:blogger.com,1999:blog-7423880838207203660.post-60145796790281594012010-07-19T16:43:06.487-04:002010-07-19T16:43:06.487-04:00You should consult the journal Chest as bronchiodi...You should consult the journal Chest as bronchiodilators have, in fact, been shown to remove mucus.<br /><br />If you wish to be taken seriously by anyone with even a basic knowledge of medicine and pharmocology, I suggest that you change the tone of your writing. Simply stating things are 'lies' makes you look uneducated and uninformed. You repeatedly lambast other websites for failing to accurately reference, yet you do the same thing yourself. You also have a significant tendency to simply ignore the reserach which doesn't support your position.<br /><br />I agree that bronchiolators are over-prescribed (HMOs are in large part to blame for this). But the way your site is presented it is the last site I would send anyone to for information.PHS doctornoreply@blogger.comtag:blogger.com,1999:blog-7423880838207203660.post-50903871437917012832010-03-28T11:45:33.132-04:002010-03-28T11:45:33.132-04:00I agree with everything you said. Not only does it...I agree with everything you said. Not only does it not work, I hate running up the bills of people knowing it doesn't work.Glennahttp://www.afridgefulloffood.typepad.com/gsspotnoreply@blogger.com